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General NPI Number Information
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NPI Number | 1093142762
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Entity Type | Individual
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Provider Name | COLLEEN QUISUMBING MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/26/2013
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 355 W OLIVE AVE STE 209
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City | SUNNYVALE
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State | CA
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Zip | 94086-7660
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Country | US
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Telephone | 669-225-8270
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1546
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94042-1546
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Country | US
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Telephone | 669-225-8270
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 53094
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License Number State | CA
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